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This version of the form is not currently in use and is provided for reference only. Download this version of
Form WCB-4A
for the current year.
Form WCB-4A Consent Between Employer and Employee - Maine
What Is Form WCB-4A?
This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WCB-4A?
A: Form WCB-4A is a Consent Between Employer and Employee in Maine.
Q: What is the purpose of Form WCB-4A?
A: The purpose of Form WCB-4A is to establish the consent between the employer and employee regarding the release of medical records for workers' compensation purposes.
Q: Who needs to fill out Form WCB-4A?
A: Both the employer and the employee need to fill out Form WCB-4A.
Q: Is Form WCB-4A mandatory?
A: Yes, Form WCB-4A is mandatory for employers and employees in Maine when there is a workers' compensation claim.
Form Details:
- Released on April 11, 2023;
- The latest edition provided by the Maine Workers' Compensation Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form WCB-4A by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
